It Doesn't Have To Be This Way
Back in elementary school, my kids, Anna and Peter, were often mistaken for twins. But in fact they were born two years apart, and, as I like to tell them, they have radically different ROIs (returns on investment).
Anna was born in Hong Kong. Had I been less of a Nervous Nellie—a much nicer term than “geriatric mother” by the way—we could have gone to a public hospital (my Montana-born husband Chris was a permanent resident by then) and paid all of 100 Hong Kong dollars (about $13USD) for the delivery.
As it was, we opted for a fancy-schmancy private package: nine months of exceptional care under the watchful eye of Dr. Alex Doo; delivery at Matilda Hospital on The Peak (I remember whispering to baby Anna, “Enjoy this view while you have it”); multiple days of in-hospital care even though the birth went perfectly smoothly; and meals so tasty that Chris kept swinging by just to eat.
The point of the extended stay was—sit down for this—to send the mother home a) rested and b) confident about breastfeeding. The total cost of this gold-plated package? About $6,000. And, in the first few weeks of being home, the total cost of the midwife visits to our apartment, to ensure the baby was thriving and to check for signs of postpartum depression? Zero dollars. Those visits were simply part of Hong Kong’s public health offering.
When Peter was born two years later, we had moved back to the U.S. Both Chris and I were self-employed. I was pregnant and 40—two things that insurance companies (I swear I called every single one of them) do not like to hear. Obama was president, but the passing of Obamacare was still a year away.
We slowly realized—huh—we’re uninsurable. We are both American citizens. We both work 60-hour weeks building businesses that employ other people. Nevertheless, the most logical thing for us to do, cost-wise, is to fly back to Hong Kong and have the baby there. Chris was still a permanent resident, and by then we were 100% comfortable with the $13 public hospital delivery option. Even with airfare and three months of rental accommodations, we would have saved tens of thousands of dollars.
We couldn’t do it though. We had moved back to the States—and Bainbridge Island in particular—for two reasons: extended family and clean air. On the day that Anna was born to that gorgeous view of the South China Sea, I had never felt happier—or lonelier. I wanted to show her to my parents. (Two weeks later, they came to us, for which I am eternally grateful.)
So we rolled the dice and stayed in the U.S. The good part of being a geriatric, ahem, mature mother is that I’d been working for decades and had some savings. We paid out of pocket for every pre-natal appointment, and as the due date approached, we just hoped with all our might that this second delivery would be as uneventful as Anna’s. At the same time, we knew full well that, if anything went awry, involving any extended hospital stays, we’d likely join the millions of Americans bankrupted by medical bills.
We were lucky: for the first (and possibly last?) time in his life, Peter arrived on time and drama-free. His big sister got to meet him right away:

So did his grandparents:

More good news: I was in and out of the hospital in under 24 hours. But here’s the rub: the bill for the delivery was still more than $25,000. Yep, one night of distinctly average care in the U.S. cost four times more than nine full months of first-rate care in Hong Kong.
Why am I sharing this story now? Because I keep hearing the likes of Bernie Sanders, AOC, Zohran Mamdani, and Katie Wilson* being painted—especially by my generation and older—as frightening radicals. Four points:
1. Universal healthcare is the norm in most developed nations. There’s nothing radical about it.
2. More generally, social safety nets of various kinds are only going to become more important as AI-related layoffs** continue.
3. There’s nothing anti-capitalist or anti-business about investing in the greater good. Hong Kong was one of the most entrepreneurial places I’ve ever lived in large part because of social safety nets. It’s much easier to start a company if you’re risking only a corporate salary, not your kid’s ability to get a good education or see a doctor.
4. If by “radical” what we really mean is alarming, there is nothing more alarming right now than the consolidation of wealth and power happening before our very eyes. The grift this term is next level, and it portends nothing but pain for those on the outside of it.
You don’t have to love everything a Sanders/AOC/Mamdani/Wilson says or does—but if you still love the idea of checks and balances as much as I do, these leaders, who have aligned themselves with ordinary people not oligarchs, deserve serious consideration.
Thanks for reading,
Kate
*Don’t know who Katie Wilson is? She has a good chance of becoming Seattle’s mayor next Tuesday and—juicy tidbit alert!—as an undergrad, she dropped out of Oxford six weeks before graduating to ensure she wouldn’t lose touch with the working class. This profile of her is fascinating.
**No one in political leadership is talking about AI nearly enough. I still believe in this post with all my heart: “The 7 Questions Every Presidential Hopeful Should Have to Answer—Starting This Year.”